Effect of dexmedetomidine on stress response to tracheal extubation in neurosurgical patients

ObjectiveTo explore the effect of dexmedetomidine on stress response to tracheal extubation in neurosurgical patients.MethodsSixty patients of ASA classⅠ～Ⅱwho received neurosurgery were randomly divided into three groups(20 patients in each group),i.e.,group A,group B and control group. The patients in group A received dexmedetomidine(used by intravenous infusion pump,with a velocity of 1 μg/kg/h) after induction of anesthesia until one hour before the end of the operation. The patients in group B received dexmedetomidine(used by intravenous injection,1 μg/kg) 10 minutes before extubation. The patients in control group received equivalent volume of physiological saline. All patients received propofol(5～10 mg/kg/h),remifentanil(10～20 μ g/kg/h) and cis-atracurium(0.1～0.2 mg/kg/h) to maintain reasonable level of anesthesia during the operation. The mean arterial pressure(MAP) and heart rate(HR) were recorded before extubation,at the time of extubation,1 minute and 15 minutes after extubation. The extubation quality scores(reflected in the prevalence of cough after extubation),postoperative sedation scores,extubation and awakening times,incidence of sore throat within 24 hours after operation and total dosage of narcotic drugs were also recorded and evaluated.ResultsThe MAP and HR significantly increased at the time of extubation compared with before extubation in three groups(P0.05),and then significantly decreased(P0.05). At the time of extubation,1 minute and 15 minutes after extubation,the MAP and HR were significantly lower in group A and group B than control group(P0.05),and there were no significant difference between group A and group B(P0.05). The extubation quality scores,postoperative sedation scores,extubation and awakening times,incidence of sore throat within 24 hours after operation were significantly lower group A and group B than control group(P0.05),and there were no significant difference between group A and group B(P0.05). The total amount of sedative and analgesic drugs in group A were significantly less than group B(P0.05).ConclusionsDexmedetomidine can attenuate the stress response to tracheal extubation in neurosurgical patients. Continuous infusion of dexmedetomidine after induction of anesthesia can reduce the dosage of narcotic drugs.